In an effort to prevent premature pullouts, nasoenteric tubes are often fixed in place using a wide variety of bridling systems. Most of these systems are difficult to place in the patient, requiring great dexterity by the physician and present unusual discomfort for the patient. Other bridling systems have additional disadvantages such as the bridle system disclosed in U.S. Pat. No. 6,631,715 to Kirn. Kirn uses a flexible tube like member as the bridle for securing the nasal tube. In the preferred embodiment the flexible member having a magnetic end is inserted into the first nare of the patient and a magnetic probe is inserted into the second nare of the patient. Both the flexible member and magnetic probe are inserted just beyond the posterior border of the nasal septum. The magnetic probe retrieves the flexible member thereby looping the flexible member around the nasal septum. The flexible member remains in the patient thereby forming the bridle. Once the magnetic end of the flexible member is trimmed away both ends of the flexible member and the nasal tube are inserted into channels of a receiver thereby securing the nasal tube to the flexible member or bridle. A disadvantage to this type of bridle is that the flexible member will begin to stretch causing the diameter to decrease. As the diameter decreases the flexible member becomes dislodged from the channels of the receiver and therefore does not stay in place to secure the nasal tube.
Another type of bridle system is disclosed in U.S. Pat. No. 5,185,005 to Ballantyne. Ballantyne utilizes two magnetic insertion tools to place a bridle around the posterior nasal septum of the patient. A first insertion tool with the bridle attached is inserted into the first nostril and a second insertion tool is inserted into the second nostril of the patient until they magnetically couple behind the posterior nasal septum. Once coupled the first insertion tool is removed from the first nostril leaving the bridle coupled to the second insertion tool. The second insertion tool is then removed from the second nostril thereby pulling the bridle through the first nostril around the posterior nasal septum and out the second nostril. The disadvantage of Ballantyne is that the insertion tools consist of several unnecessary parts, such as installation tool 34 and bridle 10, that must telescope relative to each other during removal of the installation tool, a pulling cord that serves no other purpose, and a fastening plate requiring a countersunk drilled hole. These additional parts are both difficult to manufacture and time consuming to assemble. This leads to increased manufacturing costs and more opportunities for defects.
Another type of bridle system is disclosed in U.S. Pat. No. 4,778,448 to Meer. In the preferred embodiment both ends of the bridle are inserted into separate nostrils until they are present in the hypopharynx. Each end of the bridle is then extracted through the mouth of the patient using forceps. The ends of the bridle are secured together thereby forming a loop. The portion of the bridle extending out of the second nostril is then pulled so that the secured ends are pulled back through the mouth until the loop portion is contacts the posterior aspect of the nasal septum. The disadvantage of the Meer bridle system is that the time to place the bridle is time consuming and is uncomfortable for the patient.
Additional bridle systems for securing a nasal tube include attaching the tubes directly to the skin of the patient using an adhesive as described in U.S. Pat. No. 5,735,272 to Dillion et al., U.S. Pat. No. 4,823,789 to Beisang, III and U.S. Pat. No. 4,114,626 to Beran. The disadvantage to this type of system is that the adhesive is uncomfortable to the patient and can cause skin irritation. Furthermore, the adhesive will gradually lose its adhesion over time thereby becoming dislodged.
Another type of bridle system are those disclosed in U.S. Pat. No. 5,117,818 to Palfy and U.S. Pat. No. 4,282,871 to Chodorow et al. This type of system uses a harness that wraps around the patients head or behind the patients ears. The disadvantage to this type is that the harness can become easily dislodged accidentally or be easily removed by an uncooperative patient.
Therefore, there exists a need to provide a bridle system to overcome the aforementioned disadvantages and provide a system that is cost effective, easy to manufacture and easily and rapidly placed in the patient with minimal discomfort.